Health service needs and perspectives of remote forest communities in Papua New Guinea: study protocol for combined clinical and rapid anthropological assessments with parallel treatment of urgent cases
Jackie A Cassell,
Willie Pomat,
Hayley MacGregor,
Stephen L Walker,
Maxwell J F Cooper,
Jo Middleton,
Mohammad Yazid Abdad,
Emilie Beauchamp,
Gavin Colthart,
Francesca Dem,
James Fairhead,
Caroline L Grundy,
Michael G Head,
Joao Inacio,
Mavis Jimbudo,
Christopher Iain Jones,
Martina Konecna,
Moses Laman,
Vojtech Novotny,
Mika Peck,
Jason Paliau,
Jonah Philip,
Chrissy H Roberts,
Shen Sui,
Alan J Stewart
Affiliations
Jackie A Cassell
1 Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
Willie Pomat
Papua New Guinea Institute of Medical Research, Goroka/Madang, Papua New Guinea
Hayley MacGregor
Health and Nutrition Research Cluster, Institute of Development Studies, Falmer, UK
Stephen L Walker
Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
Maxwell J F Cooper
Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, UK
Jo Middleton
Department of Primary Care and Public Health, Brighton and Sussex Medical School, Falmer, UK
Mohammad Yazid Abdad
Papua New Guinea Institute of Medical Research, Goroka/Madang, Papua New Guinea
Emilie Beauchamp
International Institute for Environment and Development, London, UK
Gavin Colthart
Department of Primary Care and Public Health, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
Francesca Dem
New Guinea Binatang Research Centre, Madang, Papua New Guinea
James Fairhead
Department of Anthropology, University of Sussex, Falmer, UK
Caroline L Grundy
Sussex Sustainability Research Programme, University of Sussex, Falmer, UK
Michael G Head
Clinical Informatics Research Unit, Faculty of Medicine, University of Southampton, Southampton, UK
Joao Inacio
School of Applied Sciences, Cockcroft Building, University of Brighton, Brighton, UK
Mavis Jimbudo
New Guinea Binatang Research Centre, Madang, Papua New Guinea
Christopher Iain Jones
Medical Statistics, Brighton and Sussex Medical School, Watson Building, University of Brighton, Falmer, UK
Martina Konecna
Zoology, Faculty of Science, University of South Bohemia, Ceske Budejovice, Czech Republic
Moses Laman
Papua New Guinea Institute of Medical Research, Port Moresby, Papua New Guinea
Vojtech Novotny
Department of Zoology, Faculty of Science, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
Mika Peck
Department of Ecology and Evolution, University of Sussex, Falmer, UK
Jason Paliau
New Guinea Binatang Research Centre, Madang, Papua New Guinea
Jonah Philip
New Guinea Binatang Research Centre, Madang, Papua New Guinea
Chrissy H Roberts
Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
Shen Sui
New Guinea Binatang Research Centre, Madang, Papua New Guinea
Alan J Stewart
Department of Ecology and Evolution, University of Sussex, Falmer, UK
Introduction Our project follows community requests for health service incorporation into conservation collaborations in the rainforests of Papua New Guinea (PNG). This protocol is for health needs assessments, our first step in coplanning medical provision in communities with no existing health data.Methods and analysis The study includes clinical assessments and rapid anthropological assessment procedures (RAP) exploring the health needs and perspectives of partner communities in two areas, conducted over 6 weeks fieldwork. First, in Wanang village (population c.200), which is set in lowland rainforest. Second, in six communities (population c.3000) along an altitudinal transect up the highest mountain in PNG, Mount Wilhelm. Individual primary care assessments incorporate physical examinations and questioning (providing qualitative and quantitative data) while RAP includes focus groups, interviews and field observations (providing qualitative data). Given absence of in-community primary care, treatments are offered alongside research activity but will not form part of the study. Data are collected by a research fellow, primary care clinician and two PNG research technicians. After quantitative and qualitative analyses, we will report: ethnoclassifications of disease, causes, symptoms and perceived appropriate treatment; community rankings of disease importance and service needs; attitudes regarding health service provision; disease burdens and associations with altitudinal-related variables and cultural practices. To aid wider use study tools are in online supplemental file, and paper and ODK versions are available free from the corresponding author.Ethics and dissemination Challenges include supporting informed consent in communities with low literacy and diverse cultures, moral duties to provide treatment alongside research in medically underserved areas while minimising risks of therapeutic misconception and inappropriate inducement, and PNG research capacity building. Brighton and Sussex Medical School (UK), PNG Institute of Medical Research and PNG Medical Research Advisory Committee have approved the study. Dissemination will be via journals, village meetings and plain language summaries.
